It was the first time there was a net drop in the number of clinics nationwide, according to Merchant Medicine, a research and consulting shop that has been tracking the field for a few years.

The clinics — which are typically staffed by nurse practitioners and tucked into drugstores and big-box retailers such as Wal-Mart — treat walk-in patients for simple ailments.

Fans say they fill a niche that primary care is missing; opponents say the make fragmentation of care worse. The market seems to be saying it’s not as easy to turn a profit with a retail clinic as many investors thought.

“The track record of private investors and venture-capital firms has been abysmal,” Tom Charland, CEO of Merchant Medicine, told the Trib. Earlier this year, Charland told the WSJ that problems in the field bear some resemblance to the dot com bubble.

But retailers who back clinics in their own stores are more willing to endure the initial losses that go with setting up the clinics. And the continued expansion by retailer-owned clinics is likely to mean overall growth in the field will continue.

Walgreen, for example, plans to add hundreds of company-owned in-store clinics by the end of the year.

Comments (5 of 31)

These retail clinics are putting the "doc in a box" in more ways than one. As many of the comments have already said, there's just not a whole lot of money in this model, so physicians/other medical practitioners are in a box also in terms of how well they can cope with their own financial problems. There are plenty of high-dollar healthcare investments, venture capital and medical device funding for medical professionals with the cash to spare, but what do we do for these people who are trying to do the right thing and just barely making ends meet? Medicine certainly doesn't have to be a goldmine, but medical professionals need to be fairly compensated for their training and skill.

11:51 am July 29, 2008

P Smith wrote :

We used to call these "Doc in the Box" when strip mall after hours clinics were introduced, and they went broke because no one wanted to pay. The reality of payment for primary care is simply that ladies pay more for a hairstyle then we pay a PCP or NP to provide basic healthcare, so convenience care has a niche, but it will not solve access issues and our Emergency rooms will still be overcrowded.

3:17 am July 29, 2008

To Dr Chaillet... wrote :

Why would it diminish interest in primary care among medical students? It's been pointed out that these clinics are only there to handle certain specific "quick fix" things. It seems then that the most likely thing to be affected would be a student's ego. If that's the case, it's a shame.

7:39 pm July 27, 2008

Jim Chaillet, MD wrote :

Synthesizing the above and adding in my own experience as a family physician, I believe this model will succeed in some markets ,at least, in the short run; however,it will accelerate the deterioration of primary care as an area of medical student interest and as a necessary foundation to an affordable and , ultimately, effective health care system.

6:51 pm July 27, 2008

Old Doc wrote :

The hiring of a prescriber by pharmacies, especially a limited liscensed practitioner who is not trained to exercise independent professional judgement, is a blatant and dangerous conflict of interest that reverses advancements made in the repression of quackery and unprofessional exploitation of patients made a hundred years ago.